Utilization Management Nurse Consultant
Remote · from United States
Core
Review clinical cases and make coverage determinations using evidence-based guidelines to ensure members receive the right care at the right time.
Role type
Utilization Management Nurse Consultant (Clinical Precertification)
Builds
Coverage determinations and care coordination for Medicare members with complex spine conditions
Domain
Healthcare / Utilization Management
Required skills
Clinical assessment, Evidence-based guideline application, Care coordination, Microsoft Office proficiency, State RN licensure
Preferred skills
Utilization Management experience, Managed care background, MedCompass familiarity, Ambulatory surgery experience, BSN degree